Retinopathy of prematurity (ROP) | Diagnosis & treatments in Turkey

What is retinopathy of prematurity (ROP)?

Retinopathy of prematurity (ROP), also known as retrolental fibroplasia, is an eye disease that affects infants born prematurely. It is characterized by abnormal growth of blood vessels in the retina, which can lead to serious complications and even blindness if not treated.

The earlier an infant is born, the greater the risk of developing POR. In addition, the risk is even greater in :

• Birth weight of less than 1 kg (between 47% and 80% risk of being affected by this disease).
• Respiratory problems requiring prolonged oxygenation.
• Infections, cerebral hemorrhages or bronchopulmonary dysplasia.

Fortunately, there are treatments available in Turkey! Laser photocoagulation and anti-VEGF injections can significantly reduce the risk of blindness in premature babies. Early detection and appropriate treatment are essential to preserving the vision of these vulnerable babies.

Need medical advice or treatment in Turkey? Contact us now and make sure your child gets the best care!

Stages of retinopathy of prematurity

Retinopathy of prematurity (ROP) manifests itself in different ways and can affect different areas of the retina. It is graded in stages from 1 to 5 and can also affect different areas of the retina, from the center to the periphery (zones I to III). Fortunately, most babies with this condition are in stages 1 or 2, which are often less severe.

• Stage 1: Presence of a fine line of demarcation in the retina.
• Stage 2: Appearance of a bulge of tissue at the level of the demarcation line.
• Stage 3: Abnormal growth of blood vessels outside the retina.
• Stage 4: Abnormal growth of blood vessels, leading to partial retinal detachment.
• Stage 5: Total detachment of the retina, leading to blindness.

In stages 1 and 2, the retinopathy of prematurity is usually mild and may resolve on its own without affecting the baby's vision. However, it is important to monitor the progress of the disease because it can sometimes get worse.

When the disease reaches stages 4 and 5, the retina may be partially or completely detached, requiring urgent treatment to prevent vision loss.

Acting quickly is crucial to preventing serious complications and preserving your baby's vision. If you have a premature baby, make sure he or she is monitored regularly by a specialist.

When and how is ROP diagnosed?

Screening for retinopathy of prematurity (ROP) is essential to prevent serious complications. It usually begins as early as 31ᵉ weeks of gestation or at birth, as the disease often manifests between 32ᵉ and 34ᵉ weeks of gestation. However, pediatricians routinely recommend screening for all newborns weighing less than 1.5 kg or born before 30 weeks' gestation.

The diagnosis of retinopathy of prematurity is based on an examination of the back of the eye, called an ophthalmoscopy. This exam examines the blood vessels of the retina and looks for signs of the disease.

During this examination, two main findings can be observed:

• Mild case: A line of demarcation and a ridge may appear, indicating a mild form of the disease that requires monitoring.
• Severe: A proliferation of abnormal blood vessels in the retina, indicating a more severe form that may require urgent treatment.

Early diagnosis is essential to avoid the risk of retinal detachment and to preserve the baby's vision.

Contact Turquie Santé now to arrange a fast and reliable diagnosis at one of the best medical centers in Turkey. Our specialists will provide you with personalized care to protect your baby's vision. Book your consultation today!

Treatment of retinopathy of prematurity in Turkey

Most retinopathies of prematurity are benign and resolve on their own without causing vision loss. This happens when the blood vessels in the retina return to normal development. But in more serious cases, specific treatments are needed to preserve vision.

Choosing a treatment

The choice of treatment is made very carefully and depends on several factors. First, doctors assess the severity of the POR by looking at its type, location, and stage of development. They also consider your child's gestational age, general health, and any underlying medical conditions. This careful assessment helps to rule out inappropriate treatment and ensure optimal follow-up after surgery.

Treatment options for POR

Treatment options for severe retinopathy include

• Cryotherapy (cold treatment): Cryotherapy, historically used to treat POR, involves the application of cold to limit the spread of abnormal blood vessels. However, it has been used less frequently since the 1980s because it causes more inflammation than other, more effective treatments, such as laser photocoagulation.
• Laser photocoagulation (reference treatment) : Laser photocoagulation is currently the most common and effective treatment for retinopathy of prematurity. This treatment uses a laser beam to destroy areas of the retina affected by ischemia, thereby reducing the production of growth factors responsible for the abnormal blood vessels. It provides better long-term results than cryotherapy. The treatment is quick, with results seen in as little as one session. Close follow-up every 1–2 weeks is necessary to monitor the maturation of the blood vessels.
• Bevacizumab treatment (a promising advance): Bevacizumab is a monoclonal antibody that blocks vascular endothelial growth factor (VEGF),which is responsible for the formation of abnormal blood vessels. This recent treatment has shown positive results in halting disease progression in infants. Compared with laser photocoagulation, bevacizumab has a lower recurrence rate and a lower incidence of myopia. However, it remains a second-line option due to certain risks such as infection and the need for high doses.

Other treatments and follow-up

In very severe cases, when the retina is completely detached, vitrectomy (removal of the lens and surgery on the retina) may be considered. However, this procedure is used only as a last resort because of its limited benefit.

Even if retinopathy of prematurity appears to resolve on its own, close medical follow-up is essential. Ophthalmologists recommend examinations every 1-2 weeks during the critical period, followed by regular examinations in the long term. This helps to prevent serious complications such as secondary glaucoma or reduced eye growth, especially after laser treatment.

For infants who have undergone laser photocoagulation, lifelong follow-up is essential, with annual visits to detect any complications or recurrences.

Management of retinopathy of prematurity in Turkey

Retinopathy of prematurity (ROP) requires expert and prompt treatment. In Turkey, this treatment is provided by a multidisciplinary team of professionals, including ophthalmologists-pediatricians, vitreoretinal surgeons, neonatologists, pediatric anesthesiologists, as well as nurses and orthoptists. These specialists work in state-of-the-art medical facilities that are perfectly adapted to the needs of premature infants.

Turquie Santé's partner hospitals are internationally recognized for their excellence. They offer the services of world-renowned specialists, ensuring the highest quality of care for your child. Professional, caring, and attentive hospital staff will be with you every step of the way to ensure a stress-free care experience.

In addition to first-rate care, you'll benefit from the best prices for the treatment of retinopathy of prematurity. Our partner clinics combine quality care with affordable pricing, allowing you to provide the best care for your child without compromising your finances.

For detailed information on ROP treatment and pricing, simply fill out the form on our website. You can also benefit from a free teleconsultation with our experts and a personalized quote based on your child's specific needs.

Don't leave your baby's health to chance. Contact us today and choose the best care for your baby's vision!